Renal cell cancer 9 1 0 2 High incidence in North America and - PowerPoint PPT Presentation

Renal cell cancer 9 1 0 2 • High incidence in North America and s Western Europe s a l • Heterogeneous disease with c r different histological subtypes e t and disease biology s a M • Local treatment by surgery, role for surgery in oligometastatic disease R B • Treatment by TKI, VEGF and Checkpoint E Inhibition E O M S E - O S E New Cases 948 Deaths 448 data from http://www.globocan.iarc.fr 2012

Renal Cell Cancer in Europe 2018 9 1 0 Incidence 2 Mortality s s a l c r e t s a M R B E E O M S E - O S E https://ecis.jrc.ec.europa.eu

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E Cohen & McGovern NEM 2005;353:2477

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

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Metastastic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Axitinib Sunitinib Everolimus B Nivolumab Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Temsirolimus Everolimus S IFN & Beva E Everolimus HD IL-2 - Sorafenib O S E

9 1 0 2 s s a l c r e t s a Local & locally advanced M R B E E O M S E - O S E

Male, 64 years presents with flank pain 9 1 0 2 s s Large right-sided mass, no distant metastases a l c r e t s a M R B E E O M S E - O S E

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Axitinib Sunitinib Everolimus B Nivolumab Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Temsirolimus Everolimus S IFN & Beva E Everolimus HD IL-2 - Sorafenib O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Axitinib Sunitinib Everolimus B Nivolumab Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Temsirolimus Everolimus S IFN & Beva E Everolimus HD IL-2 - Sorafenib O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Axitinib Sunitinib Everolimus B Nivolumab Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Everolimus S Temsirolimus E IFN & Beva Everolimus - HD IL-2 Sorafenib O S E

9 1 0 2 s s a l c r e t s a Metastatic M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E Prognosis ? - O S E

9 1 0 2 s s a l c r e t s International mRCC Database Consortium (IMDC) Criteria<br /> a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s IMDC Criteria in First-Line Targeted Therapy a M R B E E O M S E - O S E Presented By Daniel Heng at 2018 ASCO Annual Meeting

9 1 0 2 s s a l c r e t s IMDC Criteria in Second-Line Targeted Therapy a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s IMDC Criteria in Third-Line Targeted Therapy a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s IMDC in Non-clear Cell RCC <br />Kroeger N et al Cancer 2013 a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E Management Primary ? - O S E

9 1 0 2 s s a l c r e t s CARMENA: Prospective, multicenter, open-label, randomized, phase 3 non-inferiority study a M R B E E O M S E - O S E Presented By Arnaud Mejean at 2018 ASCO Annual Meeting

9 1 0 2 s s a l c r e t s Patient population a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s Overall <br />survival (ITT) a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E NEJM 2018; 379:417

9 1 0 2 s s a l c r e t s a M R B E E O M S E First-line treatment ? - O S E

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Nivolumab Sunitinib Everolimus B Axitinib Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Everolimus Temsirolimus S IFN & Beva Everolimus E HD IL-2 Sorafenib - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E NEJM 2013;369:722

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2018 l c r e t s a Metastatic Metastatic Metastatic M R Nivolumab Sunitinib Everolimus B Axitinib Pazopanib Sorafenib E E Cabozantinib O Lenvatinib & M Everolimus Temsirolimus S IFN & Beva Everolimus E HD IL-2 Sorafenib - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E Escudier et al ESMO 2017 LBA5

24.980.- CHF per 6 weeks 9 1 5.476.- CHF per 6 weeks 0 2 s s a l c r e t s a M R B E E O M S E - O S E

9 23.377.- CHF per 6 weeks 1 0 5.476.- CHF per 6 weeks 2 s s a l c r e t s a M R B E E O M S E - O S E

21.307.- CHF per 6 weeks 9 1 5.476.- CHF per 6 weeks 0 2 s s a l c r e t s a M R B E E O M S E - O S E

9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2019 l c r e t s a Metastatic Metastatic Metastatic M R ? Axitinib Sunitinib ? Everolimus B Pazopanib ? Nivolumab ? Sorafenib E Nivo & Ipi E ? Cabozantinib Pem & Axitinib O ? Lenvatinib & Ave & Axitinib M Everolimus Atezo & Bev S E ? Everolimus - ? Sorafenib O S E 12-15 months ???

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2019 l c r e t s a Metastatic Metastatic Metastatic M R ? Axitinib Sunitinib ? Everolimus B Pazopanib ? Nivolumab ? Sorafenib E Nivo & Ipi E ? Cabozantinib Pem & Axitinib O ? Lenvatinib & Ave & Axitinib M Everolimus Atezo & Bev S E ? Everolimus - ? Sorafenib O S E 12-15 months ???

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2019 l c r e t s a Metastatic Metastatic Metastatic M R ? Axitinib Sunitinib ? Everolimus B Pazopanib ? Nivolumab ? Sorafenib E Nivo & Ipi E ? Cabozantinib Pem & Axitinib O ? Lenvatinib & Ave & Axitinib M Everolimus Atezo & Bev S E ? Everolimus - ? Sorafenib O S E 12-15 months ???

Metastatic Renal Cell Cancer 9 1 0 2 s s a Renal Cancer Drug Therapy 2019 l c r e t s a Metastatic Metastatic Metastatic M R ? Axitinib Sunitinib ? Everolimus B Pazopanib ? Nivolumab ? Sorafenib E Nivo & Ipi E ? Cabozantinib Pem & Axitinib O ? Lenvatinib & Ave & Axitinib M Everolimus Atezo & Bev S E ? Everolimus - ? Sorafenib O S E 12-15 months ???

Plenary Session 9 1 0 2 s s a l c r e t s a M R B E E O M S E - 2019 O S E

Plenary Session 9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E

Plenary Session 9 1 0 2 s s a l c r e t s a M R B E E O M S E - O S E